| |
222 S Herlong Ave Rock Hill SC 29732-1158 | |
(803) 329-1234 | |
Not Available |
Full Name | |
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Speciality | Psychiatric Unit |
Location | 222 S Herlong Ave, Rock Hill, South Carolina |
Authorized Official Name and Position | Steve Gilmore (CFO) |
Authorized Official Contact | 8033296829 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Po Box 740772 Atlanta GA 30374-0772 Ph: (803) 329-6730 | 222 S Herlong Ave Rock Hill SC 29732-1158 Ph: (803) 329-1234 |
NPI Number | 1932134384 |
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Provider Enumeration Date | 07/12/2006 |
Last Update Date | 03/23/2022 |
Certification Date | 03/23/2022 |
Medicare PECOS PAC ID | 8022116672 |
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Medicare Enrollment ID | O20091221000530 |
Identifier | Type | State | Issuer |
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1932134384 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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273R00000X | Psychiatric Unit | 417 (South Carolina) | Primary |
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